PB2666: MAIN DISORDERS AND COAGULATION PARAMETERS IN PATIENTS WITH COVID-19
Authors: Valentyna Kubarova, Nadiia Goryainova, Svitlana Burnaeva, Bohdana Kuiavovych
Journal: HemaSphere (2023)

Topic: 34. Thrombosis and vascular biology - Biology & Translational Research Background: Although the exact pathogenesis of coronavirus disease 2019 (COVID-19) currently remains known not enough, its complex nature is gradually being revealed. COVID-19 is a disease caused by the SARS-CoV-2 virus and leads to respiratory dysfunction. Studies of hemostatic parameters have shown that COVID-19 significantly affects the disruption of the blood coagulation system and can contribute to coagulation and thrombotic events. The basis of hemostasis disorders is inflammation and cytokine storms. Many patients with COVID-19 have hemostasis disorders, such as disseminated intravascular coagulation and other coagulopathy. The results of our study, as well as the results of other authors’ research, indicate that dysfunction of hemostasis is one of the main pathogenetic mechanism of the disease and may be the most common cause of death. Studying the parameters of hemostasis should help establish predictors of prognosis of COVID-19 in patients. It is important to understand the pathogenetic changes in the hemostasis system and develop an effective treatment, prognosis severity of the disease. Aims: Determine the association between high levels of D-dimer, fibrinogen and the severity of COVID-19 to establish predictors of the course of the disease and its prognosis. Methods: This retrospective study included 45 patients with COVID-19 who consulted a hematologist. The diagnosis was confirmed by reverse-transcription polymerase chain reaction. To assess the state of hemostasis, the indicators of D-dimer, fibrinogen, prothrombin time (PT), thrombin time (TT) and activated partial thromboplastin time (APTT) of patients were determined. Results: Impaired coagulation parameters have been observed in 85% with COVID-19. Thus, among all patients participating in the study, 23 (51%) patients had a course of moderate disease (9 women and 14 men). The asymptomatic or mild disease was present in 12 (26%) patients (8 women and 4 men). Severe disease was observed in 10 (23%) patients (5 women and 5 men). There were changes in the indicators of D-dimer, fibrinogen, PT, APTT, and TT in the coagulogram in all patients. D-dimer was within the normal range of 0.41 ± 0.1 μg/ml in 8 patients. In 82% patients, D-dimer values ranged from 1.48 ± 0.9 μg/ml. In 85% patients were also changes (growth) in fibrinogen – an average value of 502,1 ± 97,0 mg/dL. In severe cases higher levels of fibrinogen and D-dimer in the early stages were observed, and their levels fluctuated as the disease progressed. Such data indicate a significant inflammatory reaction against the background of the development of hemostasiopathies, which significantly affect the severity of the course. Summary/Conclusion: D-dimer is an independent marker of inflammatory response and is a prognostic sign of early prevention of thrombotic complications. Hemostasiological disorders are common among patients with COVID-19 and lead to thrombotic complications. High levels of D-dimer, fibrinogen and changes PT, APTT can predict the severity and prognosis of COVID-19. Early detection of hemostasiological disorders in patients with COVID-19 is a valuable diagnostic criterion for choosing treatment tactics that reduce the risk of severe complications and mortality. Further study of hemostasiological changes will deepen our knowledge about the pathogenesis of the body’s response to the cytokine storm. Keywords: COVID-19, Hemostasis